USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 3
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2 years
Due To Interventumban heart
?.
OTHER SIGN CONDITIONS
gangrène left foot
Major findings:
Of operations ..
have - lumber sympa the Bang
Date of operation.
1/6/51
Was autopsy performed
What test confirmed diagnosis?
no.
5 Was disease or injury in any way related to occupation of deceased?
If so, specify. ..
(Signed)
(Address) 25 Sturges ST. wochenDate
M. D.
1/7 1957 MOTHER (City) North Brookfield (State or country) Massachusetts
Winthrop Cemetery Winthrop Place of Burial or Cremation
DATE OF BURIAL
January 10,1951
19
7 NAME OF
FUNERAL DIRECTOR
alfred B. Manche
ADDRESS
174 Winthrop St, Winthrop
Received and filed
JAN 15 1
19
(Registrar)
10a If married, widowed, or divorced
HUSBAND of .. Anna Frances Stallery
(Give maiden name of wife in full)"
(or) WIFE of (Husband's name in full)
DISEASE OR CONDITION DIRECTLY LEADIYO TO DEATH (a)
aceite imprendide
infact.
13 Usual
Occupation :
Architects inspector
(Kind of work done during most of working life)
14 Industry or Business: Commercial Architects
15 Social Security No010-18-0112
16 BIRTHPLACE (City North Brookfield (State or country) Massachusetts
17 NAME OF FATHER John Lawton Hibbard
PARENTS
18 BIRTHPLACE OF FATHER (City) West Brookfield (State or country) Massachusetts
19 MAIDEN NAME OF MOTHER Abigail Ayers Poland
20 BIRTHPLACE OF
Atty. R. Gaynor Wellings 1 Court St, Boston, Mass
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burialpr transit permit was issued: Walter S- Bakery
(Sknature of) Ment of Board of Health or other) Health Officer
(Official Designation) (Date of Issue of Permit9 1/9 /51
NSTRUCTIONS FOR ICAL CERTIFICATE
In giving SE OF DEATH do not enter ore than one use for each (a), (b) and (c)
This does not mean ode of dying, such rt failure, asthenia, t means the disease. mplications which death.
forbid conditions. , giving rise to the cause (a) stating underlying cause
Conditions contrib- to the death but not I to the disease or ion causing death.
'50M (B)- 12-49-900722
6
(Day)
That I attended deceased from
195b
n
195, death is said to
(Was deceased a U. S. War Veteran, if so specify WAR)
W WI
(a) Residence. No. (Usual place of abode)
PHYSICIAN - IMPORTANT -
Registered No.
21 Informant (Address)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . . Gen. Laws, Chap. 46, See. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one ceinetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be. a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is
caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner of cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or fellowing abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. . . - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made.
. Chap. 114, See. 46, G. L., (Tereentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deathsonly as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very import- ant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the oeeupation by the appropriate terms, as housekeeper-private family, eook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE . DATE OF DISCHARGE
Febuary 15, 1918
February 13,1919
RANK, RATING
Major
ORGANIZATION AND OUTFIT
U. S. Army Quartermasters Corp
SERVICE NUMBER ..
326-C.R .- O.P.
ORM R-302 1
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible
+
PLACE OF DEATH
Cesel (County) Salem (City or Town) Salem Hospital No.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Salem ... (City or town making return)
Registered No. ...
j(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
Female Inf tuttie
(If deceased is a married, widowed or divorced woman, give also maiden name.)
28 Creo Que
St.
Wintherb, mare
(If nonresident, give city of town and State)
Length of stay: In place of death. .......... years. .months. ...... .days. In place of residence. ........ .years. months. .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
22
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the ward)
Single
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of (Husband's name in full)
11 IF STILLBORN. enter that fact here.
Stillborn
12
AGE
Years
Months.
Days
If under 24 hours
Hours
.Minutes
13 Usual
Occupation :
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No. Daten mais
16 BIRTHPLACE (City) ..
(State or country)
17 NAME OF FATHER Richard A. Sutil
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Lapin mars
19 MAIDEN NAME
OF MOTHER Dorothy a. Drecoll
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Breton mars
Quine Que
6 Place of Burial or Cremation (City of Town)
DATE OF BURIAL
Van 9,
195
21 Informant (Address)
A TRUE COPY.
ATTEST:
(Registrar of City or Town where death occurred)
Received and filed FEB 8 1351
19
(Registrar of City or Town where deceased resided)
PARENTS
5 Was disease or injury in any way related to occupation of deceased? If so. specify 2 Enpremiuall (Signed) M. D (Address) Sally Mas Date 1-7 105/
Date of operation
Was autopsy performed?
What test confirmed diagnosis ?.
TWEEK ONSET AND DEATH
ANTE
Due To
CEDENT (b)
CAUSES
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
7 NAME OF
FUNERAL DIRECTOR ..
.& Richardson
ADDRESS Lapin, masa
DATE FILED
1-
8
100/
3 DATE OF
DEATH
Han
(Month)
(Dáy)
7
1951
(Year)
4 I HEREBY CERTIFY,
That I
attended deceased from
19 to
19
I last saw h ...
alive on
19
death is said to
have occurred on the date stated above, at
m.
INTERVAL BE-
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Stillborn
50m-(e)-10-48-24658
2 FULL NAME
(a) Residence. No. (Usual place of abode)
(Was deceased a U. S. War Veteran, if so specify WAR).
Aschaff A Buttil
M R-302 1
after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
PLACE OF DEATH
suffolk
(County)
Boston
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF
BOSTON
(City or town making return)
Registered No.
1 54
8
[(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME
Israel Canner
(If deceased is a married, widowed or divorced woman, give also maiden name.)
29 Perkins St.
St.
Winthrop
(a) Residence.
No.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death.
.years
1
months.
5days. In place of residence.
20 years
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
January 8, 1951
DEATH
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
Dec. 2
15 0
to.
Jan ...
8
1957
I last saw
h
alive on
im
Jan.
8
19.5.1. death is said to
have occurred on the date stated above, at.
4:00A .m.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN. enter that fact here.
12
AGE
83 Years.
Months.
.Days
If under 24 hours
Hours ...
Minutes
13 Usual
Furniture dealer
Occupation:
(Kind of work done during most of working life)
14 Industry
retired
or Business :.
none
15 Social Security No.
16 BIRTHPLACE (City).
(State or country)
17 NAME OF
FATHER
Abraham Canner
18 BIRTHPLACE OF
FATHER (City).
(State or country)
Russia
19 MAIDEN NAME
OF MOTHER
-
20 BIRTHPLACE OF
MOTHER (City)
Russia
(State or country)
Morris Canner
7 NAME OF
FUNERAL DIRECTOR®
Benjamin Birnbach
ADDRESS
10 Washington St. DorchestLATTES
Received and filed.
JAN 23 1951
19
(Registrar of City or Town where deceased resided)
10a If married, widowed, or divorced
HUSBAND of
Rose Goldberg
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Respiratory .... failure few
ANTE
Due ToCarcinoma of
CEDENT (b)
CAUSES
ascending colon
yrs .
Due To
(c)
OTHER
SIGNIFICANTarteriosclerotic ht.
....
CONDITIONS
dis.
Major findings:
Of operations
carcinomaof ascending col
Date of operation.
Was autopsy performed?
no
What test confirmed diagnosis ?.
S Was disease or injury in any way related to occupation of deceased ?...... )O If so, specify.
(Signed)
Burrell w. Josephs
M. D.
(Address)Beth Israel Jogo Date 1-8-5]19
6
... Winthrop .... Cem.
Everett.
(City of Town)
Place of Burial of Cremation
DATE OF BURIAL
January 8,
30
21
Informant
(Address)
A TRUE COPY Charles 2 Lata
JAN. 10, 1951
DATE FILED
19
10 SINGLE
(write the word)
8 SEX
Male
9 COLOR OR RACE
White
MARRIED
WIDOWED™
or DIVORCED
married
-
min.
PARENTS
-
25m-(b)-11-49-900,475
No. Beth Israel Hosp.
CERTIFICATE OF DEATH
(Was deceased a
U. S. War Veteran,
( if so specify WAR)
+
Suffolk (County)
Boston 2/10/5/
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
[ (If death occurred in a hospital or institution,
PHYSICIAN - IMPORTANT
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
235
Cart Eagle
St.
Cast
Sosten
(If nonresident, give city or town and State)
Length of stay: In place of death years
months 16 days. In place of residence years
months .days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF DEATH
lam (Month)
9 (Day)
1951 (Year)
4 I HEREBY CERTIFY,
That I attended deceased from
Dec. 24. 19
5
to
I last saw hAMalive on ...
death is said to
have occurred on the date stated above, at m. INTERVAL BE- TWEEK ONSET AND DEATH
DISEASE OR CONDITION DIRECTLY LEADOGruntu TO DEATH (a)
10
Tereabal Thrown
8 days
ANTE CEDENT (b) CAUSES
Due To
à mppolitico
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations.
Date of operation.
Was autopsy performed?
What test confirmed diagnosis ?.
5 Was disease or injury in any way related to occupation of deceased? 1000
If so, specify
Samuelu
(Signed) (Address)
HeDate 1- 9 -
1951
6 Daly Cross Place of Burtafor Cremation
Malden (City or Town)
DATE OF BURIAL.
Can-12.
5,92.3. 19
7 NAME OF FUNERAL DIRECTOR Vincent afino
ADDRESS
y Unaleca ??
E. (S.
Received and filed
JAN 15 1051
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR OR RACE Write
10 SINGLE MARRIED WIDOWED Married or DIVORCED
10a If married, widowed, or divorced HUSBAND of Juna
Di Grasquale
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN. enter that fact here.
12 AGE 6 3% Years
Months .. . Days
If under 24 hours Hours Minutes
13 Usual Occupation :
Petined
(Kind of work done during most of working life)
14 Industry or Business:
Laborer
15 Social Security No. none
16 BIRTHPLACE (City) (State or country)
Italy
17 NAME OF FATHERU
Francesco Viscione
Italy
19 MAIDEN NAME OF MOTHER
Maria Lescion(sk)
20 BIRTHPLACE OF MOTIIER (City) (State or country)
anna Di Pasquale Visione
21 Informant (Address) 235 Cast Carte St. C. B.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with ing BEFORE the burial or trangft permit was issued:
Walter A. Bakery.
Siggiture of Aging of Board of Health of other
health Officer
11/10/51
(Official Designation)
(Date of Issue of Pormit)
<
STRUCTIONS FOR AL CERTIFICATE
n giving E OF DEATH not enter re than one se for each ), (b) and (c)
is does not mean le of dying, such failure. asthenia, neans the disease, plications which death.
rbid conditions. giving rise to the use (a) stating derlying cause
ditions contrib- the death but not to the disease or n causing death.
138 2
.50M (B)-12-49-900722
PLACE OF DEATH
Winthrop (City of Town)
Wheretherap Community /vas.) give its NAME instead of street and number) No.
Ralph Viscione
(Was deceased a U. S. War Veteran,
if so specify WAR)
No
(a) Residence. No. (Usual place of abode)
fun. 9.
1951
6 45
uno
18 BIRTHPLACE OF FATHER (City) (State or country)
PARENTS
, M. D.
Italy
19
To be filed for burial permit with Board of Health or its Agent.
M R-301A 1
Registered No.
(write the wordt)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . . Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen, G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate. shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner of cause of the death, which the clerk or registrar may require. - Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. - General Laws, Chap, 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made,
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